Surgical Procedures for Ovarian Cancer

Surgery is the main treatment for ovarian cancer in all stages. The goal of surgery is to remove the cancerous tumor and preserve as much ovarian function as possible. The type of surgery depends on the stage of the cancer. The impact of ovarian or other bodily functions depends on the stage, the type of surgery needed, and overall health. Chemotherapy may be done before surgery to shrink the tumor or after surgery to kill any remaining cancer cells.

The American Congress of Obstetricians and Gynecologists (ACOG) recommends that all women with ovarian cancer have surgery performed by a gynecologic cancer specialist.

Surgery for Early Stage and Advanced Ovarian Cancer

Treatment for ovarian cancer begins with a surgery called a exploratory laparotomy. An incision is made in the abdominal wall to gain access to the pelvic and abdominal cavities. These procedures may be done during staging.

The extent of surgery depends on how advanced the cancer is. Radical surgery is the best treatment for ovarian cancer since the cancer can spread and be hard to detect. Radical surgery, which removes the most tissue, increases the chance that all the cancer cells will be removed.

Surgical procedures may include one or all of the following:

  • Abdominal hysterectomy—Removal of the uterus.
  • Bilateral salpingo-oopherectomy—Removal of both ovaries and fallopian tubes. This procedure may be recommended for women who are at high risk for ovarian cancer. Removing the ovaries before cancer is present is considered prophylactic (a preventive measure).
  • Omentectomy —Removal of the omentum, a large apron-like structure that covers the organs in the abdominal cavity.
  • Debulking —If ovarian cancer has spread into the pelvis or abdomen, as many of the tumors as possible will be removed. In some cases, this means leaving no tumors that are 1 centimeter or larger behind. It may be done on any organ in the pelvis or abdomen, such as the colon or bladder. Debulking can be done during a first or follow-up surgery.

Lymph nodes and/or other suspicious tissue will be removed and examined under a microscope for the presence of cancer cells.

In women where cancer is in a very early stage and who want to have children, a unilateral salpingo-oopherectomy (one ovary and fallopian tube) may be considered. Before starting treatment, talk to your doctor about preserving fertility.

References:

Committee on Gynecologic Practice, Society of Gynecologic Oncology. Committee Opinion No. 716: The role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Obstet Gynecol. 2017;130(3):e146-e149.
Ovarian cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900705/Ovarian-cancer. Updated November 17, 2017. Accessed January 29, 2018.
Ovarian cancer. Merck Manual Professional Version website. Available at:
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Updated March 2017. Accessed January 29, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_156. Updated October 13, 2017. Accessed January 29, 2018.
Woo YL, Kyrgiou M, Bryant A, Everett T, Dickinson HO. Centralisation of services for gynaecological cancer. Cochrane Database Syst Rev. 2012;(3):CD007945.
Last reviewed December 2017 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 11/17/2016

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